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Großhansdorf, Germany

Franzen A.M.,HNO Plastische Operationen | Schneider C.,Onkologischer Schwerpunkt | Lebentrau S.,Klinik fur Urologie und Kinderurologie | Gunzel T.,HNO Abteilung
Laryngo- Rhino- Otologie | Year: 2015

Background: Single case reports about extranodal renal cell carcinoma (RCC) metastasis to the head and neck (HN) often implicating unusual clinical follow-ups are well known. Subject of our investigation is to ascertain the true meaning of RCC for differential diagnostic of the head and neck surgion. Methods: We retrospectively review the reports of 612 patients with RCC treated in a 13-years period in the department of urology. Results: Of the 612 RCC 191 (31%) were metastatic, 3 female and 4 male (mean 66.8a, 56a-78a) presented with extranodal metastases within the HN. Extranodal locations were parotid and thyroid glands (2 ×), tongue, forehead scin, bone and paranasal sinus. Occurrence of metastases were observed in mean 40.8 months (5-87) after the primary. In one patient metastasis to the parotid gland was the only manifestation of RCC 78 month treated before, the others presented with further metastases to infraclavicular organs. Discussion: According to our results extranodal metastases of RCC to the HN are uncommon (1.1%). Therefore and because of the unusual location extranodal metastases of RCC remain a diagnostic challenge for the ENT specialist and the pathologist with peculiar knowledge of the oncological history of the patient remaining an essential condition. We found exclusive metastasis to the HN in only one of 7 cases. Nevertheless surgical treatment has to be considered in curative and symptomatic treatment strategies. © Georg Thieme Verlag KG Stuttgart · New York. Source

Heigener D.F.,Onkologischer Schwerpunkt
Atemwegs- und Lungenkrankheiten | Year: 2012

The discovery of the EML4 ALK translocation resulted in a targeted therapy within 3 years from first description. The drug crizotinib results in dramatic responses in patients harboring this molecular alteration. However, the prevalence of ALK translocation in NSCLC is small, so only few patients will benefit from this approach. As with anti-EGFR therapy, acquired resistance is described. Drugs overcoming this problem are in development. © 2012 Dustri-Verlag Dr. Karl Feistle. Source

Nehls W.,Klinik fur Pneumologie | Heigener D.F.,Onkologischer Schwerpunkt
Pneumologe | Year: 2016

Palliative medicine is inseparably linked to pulmonology because of the many incurable diseases with limited life expectancy in this field. Skills, such as communication for breaking bad news as well as shared decision-making are mandatory for doctors working in this field. Beyond that, knowledge of symptom control in addition to causal therapy for dyspnea, pain and other symptoms is also necessary. © 2015, Springer-Verlag Berlin Heidelberg. Source

Heigener D.F.,Onkologischer Schwerpunkt
Atemwegs- und Lungenkrankheiten | Year: 2012

Approximately 50% of pulmonary adenocarcinomas seem to harbor so-called "driver" mutations, which are potentially treatable. kRAS is the most frequent alteration. However, for this and many others, no proven therapeutic approach exists yet. The majority of non-small-cell lung cancers however do not harbor such a mutation. In some of these tumors, EGFR over-expression poses a potential target to treatment with cetuximab. Other molecular targets like IGFR are in different stages of clinical development. © 2012 Dustri-Verlag Dr. Karl Feistle. Source

Reck M.,Onkologischer Schwerpunkt | Gutzmer R.,Klinik und Poliklinik fur Dermatologie
Onkologie | Year: 2010

The epidermal growth factor receptor (EGFR) is expressed in a variety of human tissues and is a key mediator of numerous cellular processes. Dysregulation and overexpression of the EGFR are common features of many tumors; targeted EGFR inhibitors are therefore widely employed as therapeutic agents. Novel mechanisms associated with EGFR inhibitors induce characteristic toxicities, of which cutaneous side effects (generally termed 'skin rash') are the most common. Although this rash is generally mild to moderate in severity, it can affect compliance and/or result in dose reductions or treatmentwithdrawal. To ensure that patients can continue to receive active treatment at the optimal dose, effective treatment strategies are required to actively manage rash and aid compliance. This is important as rash is increasingly identified as a predictive marker of benefit with EGFR inhibitors. The incidence and clinical characteristics of rash, in addition to current rash management strategies, are reviewed. Our recommendations based on clinical experience are presented, with two case studies of successful rash management provided to illustrate their success. Active rash management can effectively resolve rash to ensure that patient compliance is maintained, without necessitating dose interruptions or treatment withdrawal. Copyright © 2010 S. Karger AG, Basel. Source

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